Healthcare Provider Details

I. General information

NPI: 1144262015
Provider Name (Legal Business Name): NATHAN ZANKMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 FROSTY HOLLOW RD
LEVITTOWN PA
19056-2404
US

IV. Provider business mailing address

1310 FROSTY HOLLOW RD
LEVITTOWN PA
19056-2404
US

V. Phone/Fax

Practice location:
  • Phone: 215-949-6622
  • Fax: 215-949-8357
Mailing address:
  • Phone: 215-949-6622
  • Fax: 215-949-8357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD028306-L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: